New opioid use common post-hospital discharge among Medicare beneficiaries

After an acute hospitalization, many Medicare beneficiaries submit pharmacy claims for opioid prescriptions.

New opioid use after a hospitalization is common among Medicare beneficiaries, according to research published in JAMA Internal Medicine.

Anupam B. Jena, MD, PhD, Department of Health Care Policy, Harvard Medical School, Boston, and colleagues analyzed a random sample of pharmacy claims submitted by Medicare beneficiaries who were hospitalized in 2011 and did not have an opioid prescription claim in the 60 days prior to hospitalization. The researchers aimed to estimate the frequency of opioid prescribing at hospital discharge, to document prescription variations among hospitals, and to analyze the patient factors associated with opioid prescribing.

Across 623,957 hospitalizations, 14.9% were associated with a new opioid claim; 42.5% were associated with an opioid claim after 90 days post-discharge. Across 2512 hospitals, the average adjusted rate of new opioid use within 7 days of hospitalization was 15.1%.

“Use of opioids during and shortly after an acute hospitalization is warranted in some clinical settings,” said Dr Jena. “[There is] substantial variation across hospitals and a large proportion of patients using a prescription opioid 90 days after hospitalization.

“The degree to which observed hospital variation in short- and long-term opioid use reflects variation in inappropriate prescribing at hospital discharge is unknown.”

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